Medical-Surgical Nursing, University of Wisconsin School of Nursing, Madison 53706, USA.
Nurs Clin North Am. 1968 Mar;3(1):165-78.
Venipuncture is a medical function delegated to professional nurses in some states. Each nurse must ascertain if the state in which she practices considers this a legal nursing function, and if the institution in which she is employed permits nurses to perform venipunctures. Adequate instruction and supervised practice in the technique is mandatory before a nurse performs the procedure on a patient. Psychological and physical preparation of the patient is necessary prior to a venipuncture as it is usually attended by some degree of anxiety and some restriction of activity if an infusion is ordered. Knowledge of the location, structure, and characteristics of arteries and veins is essential for patient safety. Aberrant arteries increase the hazard of venipunctures. Recognition of pathologic conditions that would preclude the use of a vein or extremity for needle insertion is imperative. The best site for a venipuncture if an infusion is to be administered is in the forearm; the least desirable site is the foot and ankle. Thrombophlebitis invariably develops to some degree whenever a needle remains in a vein for many hours, but its severity increases when a foot or ankle vein is used. The patient receiving an infusion requires nursing care determined by his particular condition, his reaction to the therapy, and the degree of immobility effected by the presence of the needle in his vein. Frequent observation of the patient and the infusion setup is essential. Many hours of practice are needed before one feels confident in performing a venipuncture. Success is contingent upon the triad of skill, knowledge, and a sensitivity to the patient who is to receive the venipuncture.
静脉穿刺是一项医学功能，在某些州被授权给专业护士。每位护士都必须确定她所在的州是否认为这是一项合法的护理功能，以及她所任职的机构是否允许护士进行静脉穿刺。在护士对患者进行该操作之前，必须进行充分的指导和监督练习。在进行静脉穿刺之前，必须对患者进行心理和身体上的准备，因为这通常会引起一定程度的焦虑，并且如果需要输液，还会限制患者的活动。了解动脉和静脉的位置、结构和特征对于患者的安全至关重要。异常的动脉会增加静脉穿刺的危险。必须认识到可能会禁止使用静脉或肢体进行针插入的病理状况。如果要进行输液，静脉穿刺的最佳部位是前臂；最不理想的部位是脚和脚踝。只要针头在静脉中停留数小时，就会不可避免地发生血栓性静脉炎，但当使用脚部或脚踝静脉时，其严重程度会增加。接受输液的患者需要根据其特定情况、对治疗的反应以及针头在静脉中引起的活动受限程度来确定护理。必须经常观察患者和输液装置。在感到有信心进行静脉穿刺之前，需要进行数小时的练习。成功取决于技能、知识和对接受静脉穿刺的患者的敏感性这三重因素。
